Conservative management of grade 1V renal injury with complete transection: a case report

Area of Science:

• Pediatric Surgery
• Urology
• Trauma Management

Background:

• Expectant management of high-grade renal injuries in children is increasingly accepted.
• Complete renal transection (Grade IV injury) represents a subgroup with poor outcomes, potentially benefiting from early intervention.

Purpose of the Study:

• To evaluate the efficacy of combined internal and external drainage for complete renal transection in a pediatric patient.
• To explore the role of external drainage in conjunction with internal stenting for severe renal trauma.

Main Methods:

• Case report of a child with complete renal transection.
• Management involved a combination of internal ureteral stenting and external drainage.
• Hemodynamic stability was maintained throughout the expectant approach.

Main Results:

• Successful non-operative management of a complete renal transection.
• The combined drainage approach facilitated healing and preserved renal function.
• Demonstrated feasibility of managing severe renal trauma expectantly.

Conclusions:

• Combined internal and external drainage can be a viable option for select pediatric patients with complete renal transection.
• This approach may offer an alternative to immediate surgical intervention for severe renal injuries.
• Further research is warranted to establish optimal timing and indications for external drainage in renal trauma management.